MR characteristics of low-flow facial vascular malformations in children and young adults

The purpose of this report is to describe the magnetic resonance (MR) imaging characteristics of low-flow vascular malformations of the face. We studied six patients ranging in age from 1 month to 20 years old, with surgically proven or clinically certain low-flow vascular malformations of the face. T1-weighted MR images of five lesions showed homogeneous intermediate to low signal intensity, similar to the signal intensity of muscle. T1-weighted images of one lesion showed mild high signal intensity and image of another demonstrated fatty infiltration. After contrast administration, images of four lesions showed moderate to marked enhancement, three diffused and one patchy. On T2-weighted sequences, five lesions were heterogeneously of high signal and one of low signal intensity. Three lesions exhibited low-signal septa, and two revealed low-signal vascular flow voids on both types of sequences. Satellite nodules were present in three instances. Low-flow vascular malformations involving the face in children and young adults have a heterogeneous and nonspecific appearance on MR images. They should be considered in the differential diagnosis of all facial masses presenting in children and young adults. Enhancement with contrast material is essential to localize the mass.